Study: More smokers would quit if state Medicaid programs covered more cessation treatments

ATLANTA — More smokers would quit if state Medicaid programs covered more cessation treatments and removed barriers to coverage, according to a Centers for Disease Control and Prevention study published in Thursday's Morbidity and Mortality Weekly Report.

“There’s evidence suggesting that smokers enrolled in Medicaid, like other smokers, want to quit and will take advantage of covered cessation treatments to help them quit for good,” commented Stephen Babb, co-author of the article.

Some of the strongest evidence comes from Massachusetts, which expanded its Medicaid cessation coverage in 2006.

“Massachusetts heavily promoted its new Medicaid cessation coverage to Medicaid enrollees and health care providers, and saw a drop in the smoking rate among Medicaid enrollees from 38% to 28%,” Babb said. There was also an almost 50% drop in hospital admissions for heart attacks among those who used the benefit. It is important that all smokers who want help quitting, including smokers enrolled in Medicaid, have access to proven cessation treatments and services.”

“States can save lives and reduce costs by providing Medicaid coverage for all proven cessation treatments, removing barriers to accessing these treatments, and promoting the expanded coverage,” stated Tim McAfee, director of the CDC’s Office on Smoking and Health. “Reducing the number of smokers will save lives and reduce health care costs.”

All 50 states and the District of Columbia cover cessation treatments for at least some Medicaid enrollees. Efforts to expand state Medicaid coverage for all smoking cessation treatments and the removal of coverage barriers have shown mixed progress over the past five years, the agency reported.

Americans enrolled in Medicaid are more likely to smoke than the general population, and smoking-related disease is a major contributor to increasing Medicaid costs. Insurance coverage of proven cessation treatments leads to more smokers using the treatments and successfully quitting smoking. A recent study from the American Journal of Preventive Medicine found that more comprehensive state Medicaid coverage was associated with increased quit rates among smokers enrolled in Medicaid.

Seven states cover all approved medications and in-person counseling cessation treatments for all Medicaid recipients. All states have some barriers to getting these treatments. The most common barriers are limits on how long treatment is covered and how much is covered per year; prior authorization requirements; and copayments.

The study compares 2008 with 2014 data and found that 41 states made changes to the treatments they covered for at least some plans or populations. Nineteen states added treatments to coverage without removing any treatments from coverage and eight states removed treatments from coverage without adding any treatments to coverage. Fourteen states both added and removed coverage.

During this same period, 38 states made changes to barriers to accessing treatments for at least some plans or populations. Nine states removed barriers without adding new barriers, 12 states added new barriers without removing existing ones, and 17 states both removed and added barriers.

Comments

Mar 31, 2014 - 5:26 PM

Marilyn C. says

Yes, no doubt reducing the number of smokers would save lives and reduce cost. However, it seems a little odd that the State (Medicaid) is not supplying all the dollars that smokers spend to smoke, but is now expected to pay for the things that would help them quit. Do you see a problem here?
Our country is full of people who want the government to pay for what they "need", so that they can continue to buy what they "want". Has anyone priced cigarettes lately? Let's get our priorities straight and require a little personal responsibility. Do the math.
Tired of paying,
Marilyn C, RPh
Somewhere in Texas

Apr 02, 2014 - 10:28 AM

mjohnsen@lf.com says

Hear,hear. But I think it's a case of an ounce of prevention equals a pound of cure. In other words, incent people to make better lifestyle choices by supplementing preventative solutions like smoking cessation today, and in the tomorrows of 10 years, 20 years save the cost of treating someone with emphysema/COPD, or worse, lung cancer.
Incidentally, there's talk of holding people who make those lifestyle choices accountable for the extra burden they place on the healthcare system. In the past we've reported on employers who not only refuse to hire smokers, but also will terminate any smokers on their payroll — quite the economic motivator to quit. And under the Affordable Care Act, insurers will be able to charge a 50% premium to smokers.
While that doesn't have any bearing on Medicaid programs, I think it will continue to raise awareness around the need to quit smoking, or better yet, never to begin smoking.
The reality is smokers smoke, and they will spend any money they have at their disposal to continue to do so. I think it makes sense to invest the hundreds of dollars per smoker today to entice them to quit before they become that hundreds of thousands of dollars of burden tomorrow.
Marilyn, thanks for commenting!

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